Medical Economics Senior Consultant

Aetna   •  

Hartford, CT

Industry: Healthcare


5 - 7 years

Posted 201 days ago

This job is no longer available.


Provides oversight and modeling in support of the organization’s strategy of medical cost trend mitigation, as it relates to our current national vendor programs; as well as analyze potential new vendor programs for cost saving opportunities. Provides analysis to senior management to support strategic and tactical operating decisions. This role will require project management, the ability to work on multiple projects, analysis skills, and technical expertise.

Fundamental Components:

* Partner and consult with National Network Contracting, Local Network Teams, and external vendors to provide medical cost analysis to assess effectiveness of managing current and new vendor programs.
* Independently design and create analytical models in order to meet the needs of internal and external customers. This will require aggregating and analyzing large amounts of medical claims data

* Responsible for building corporate expertise and reporting on all medical cost drivers
* Build medical cost analytics best practices and provide analytical support

* Turn data into information: draw conclusions from the analysis and communicate results
* Document the solution and be the subject matter expert on vendor analysis.
* Have experience creating and altering algorithms in SAS and MS Access

* Develop and present actionable recommendations to management based on analyses

* Participate in research-related activities including industry best practices and experience studies

Strong analytical ability and familiarity with advanced financial and healthcare concepts.
5-8 years demonstrated leadership and project management experience.

Ideal candidate will have a medical economics, actuarial, underwriting or informatics background.

Advanced data and analytics background required.
Ability to manage conflicting priorities and multiple projects concurrently.
Advanced excel and access skills, SAS a plus

Excellent analytical and problem solving skills

Strong verbal & written skills.

Bachelors degree in Actuarial Science, Mathematics, Statistics or other related field required

Functional - Actuarial/Modeling & tool development/1-3 Years
Functional - Information Management/Medical economics/1-3 Years
Functional - Information Management/Provides analysis and support for planning and forecasting of medical costs/1-3 Years
Functional - Information Management/Query and Database Access Tools/1-3 Years
Functional - Information Management/Provides very complex programming and analytical support for medical cost trend analysis and strategic planning/1-3 Years

Technical - Reporting Tools/SAS/1-3 Years/End User

General Business/Communicating for Impact/ADVANCED
General Business/Demonstrating Business and Industry Acumen/ADVANCED
General Business/Turning Data into Information/MASTERY

Telework Specifications:
Flexible telework / office-based schedule (can live near any office location)